军人睡眠质量及其影响因素

目的研究军人的睡眠质量,并探索相关影响因素。方法选取驻华东地区陆、海、空军及第二炮兵部队各一部共1887名军人,填写自编一般情况调查表、睡眠卫生习惯量表、匹兹堡睡眠质量指数量表(PSQI)。结果 PSQI总分为(5.41±3.09),以PSQI7为睡眠质量不佳的界值,失眠发生率12.5%。年龄(r=0.361,P0.01)、受教育程度(r=0.063,P0.05)、职别(r=0.058,P0.05)、服役时间(r=0.216,P0.01)、大量吸烟(r=0.061,P0.05)、睡前饮酒(r=0.178,P0.01)与PSQI总分相关。进入PSQI总分回归方程的变量为年龄、睡前饮酒(β=0.40,-1.54;P0.05)。结论驻华东地区军人睡眠质量尚可,睡眠质量与年龄、受教育程度、职别、大量吸烟、睡前饮酒相关,其中年龄和睡前饮酒习惯对睡眠质量有预测效应。     

抑郁症患者睡眠障碍相关因素及对预后影响调查

目的调查抑郁症患者睡眠障碍的相关因素、以及睡眠障碍对患者预后的影响。方法选择60例抑郁症患者,采用匹兹堡睡眠质量指数量表（PSQI）评估患者的主观睡眠质量,并随访3个月。结果治疗前PSQI评分与性别（F=8.67,P＜0.01）、受教育年限（r=-0.33,P＜0.01）、躯体疾病（F=6.68,P＜0.01）、家族史（F=4.04,P＜0.05）、首发与否（F=20.43,P＜0.01）、积极应对分（r=-0.44,P＜0.01）、消极应对分（r=0.23,P＜0.01）、HAMD（r=0.22,P＜0.05）、HAMA（r=0.31,P＜0.01）、SIOSS（r=0.56,P＜0.01）明显相关,治疗后PSQI评分与HAMD、HAMA、SIOSS均显著正相关（P＜0.01）。结论抑郁症患者的睡眠障碍危险因素较多,对疾病结局有不良影响。     

驻海岛官兵睡眠障碍、急性应激障碍及社会支持关系

目的探讨驻海岛官兵睡眠障碍、急性应激反应与社会支持状况的相关因素。方法采用随机整群抽样法,抽取883名驻海岛官兵作为研究组和1184名非海岛某部队官兵作为对照组,采用军人睡眠问题测量问卷、军人急性应激反应量表与军人社会支持量表进行调查,数据应用t检验、Pearson相关分析、回归分析。结果①驻海岛官兵睡眠障碍总分及各因子分均高于对照组(睡眠障碍总分t=-7.65,各因子分t=1.60~12.91,P0.05);②驻海岛官兵急性应激障碍总分及各因子分高于对照组(急性应激障碍总分t=3.79,各因子t=2.70~5.37,其中除睡眠情况因子外,其余各因子P0.05);③驻海岛官兵睡眠障碍总分与社会支持总分(r=-0.52,P0.01)及一般情况均呈负相关(r=-0.05~-0.52,P0.05);④驻海岛官兵睡眠障碍总分及各因子与急性应激障碍总分及各因子呈正相关(r=0.19~0.60,P0.01);⑤社会支持和性别是影响海岛官兵睡眠障碍的主要因素(t=-13.389,2.199;P0.05)。结论驻海岛官兵睡眠质量及应激反应均较差,应有针对性的为驻海岛官兵开展心理干预。     

西安市成年人的情绪状态和睡眠质量及其关系

目的:了解西安市成年人情绪状态和睡眠质量的特点及其关系。方法:采用简明心境量表(POMS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数量表(PSQI)对西安市603名成年人进行问卷调查。结果:1女性的愤怒情绪(t=2.641,P0.01)和抑郁情绪(t=3.910,P0.001)比男性严重,男性的自尊感比女性强(t=-2.649,P0.01);青年人精力比中年人旺盛(t=2.899,P0.01),青年人比中年人容易产生紧张情绪(t=3.298,P0.01)和疲劳情绪(t=3.850,P0.001),但是中年人的抑郁情绪比青年人严重(t=-2.040,P0.05);2本研究中近一半的成年人出现睡眠障碍。女性的睡眠质量比男性差,具体表现为女性在主观睡眠时间(t=2.580,P0.01)、睡眠潜伏期(t=3.900,P0.001)、睡眠效率(t=3.460,P0.01)和总分(t=1.490,P0.001)上得分显著高于男性。白天功能紊乱因子上青年人得分显著高于中年人(t=3.530,P0.01);3紧张、愤怒、疲劳、压抑、抑郁与主观睡眠质量、睡眠潜伏期、睡眠紊乱、白天功能紊乱和PSQI总分呈正相关关系;精力与主观睡眠质量、睡眠潜伏期、睡眠紊乱、白天功能紊乱和PSQI总分呈负相关,自尊感与主观睡眠质量、睡眠持续性、睡眠紊乱、白天功能紊乱和PSQI正相关。结论:西安市成年人情绪状态均低于我国常模,近半数人群的睡眠质量较差。睡眠质量差可能与负性情绪较多、正性情绪较少有关。     

综合医院护理人员睡眠质量与抑郁焦虑状况的相关性

目的:了解综合医院护理人员睡眠质量与抑郁焦虑状况的关系,为改善护理人员的睡眠质量提供参考。方法:采用匹兹堡睡眠指数量表(PSQI)、抑郁自评量表(SDS)、焦虑自评量表(SAS)对109名综合医院护理人员进行测评。结果:本组护理人员PSQI总分及各因子分均高于正常人群(U=5.76~15.33,P0.01),且41.3%(45/109)护理人员PSQI总分大于7分,远高于正常人群(χ2=69.11,P0.001);本组护理人员的SDS总分和SAS总分均高于我国常模(U=12.12,12.39;P0.01);SAS总分和SDS总分均与PSQI总分呈正向相关(r=0.534,0.897;P0.01)。结论:综合医院护理人员的睡眠质量较差,改善其抑郁焦虑状况有助于睡眠质量的改善。     

大学生睡眠质量与生活事件的相关性

目的:了解大学生睡眠质量与生活事件的相关性,为关注其心理健康提供实证依据。方法:分层随机抽取353名大学生使用睡眠状况自评量表(SRSS)和青少年生活事件量表(ASLEC)施测,以SPSS 17.0进行统计分析。结果:(1)大学生睡眠障碍检出率为37.96%。其中,轻度睡眠问题为33.15%,中度睡眠问题为4.53%,重度睡眠问题为0.28%;(2)女大学生睡眠质量总分、睡眠不足因子分、睡眠质量因子分、觉醒不足因子分、睡眠时间因子分、失眠后反应因子分均高于男大学生,差异有统计学意义(t=-2.352,-4.112,-2.146,-2.590,-2.567,-2.619;P0.05);大三年级大学生睡眠质量总分、觉醒不足因子分、入睡困难因子分、睡眠不稳因子分、噩梦夜惊因子分均高于其他年级,差异有统计学意义(F=4.609,3.299,3.176,3.635,6.060;P0.05)。城市成长的大学生睡眠时间因子分高于农村成长的大学生,差异有统计学意义(t=2.260,P0.05)。农村成长的大学生入睡困难因子分、失眠后反应因子分高于城市成长大学生,差异有统计学意义(t=-2.021,-2.513;P0.05)。非独生子女大学生睡眠不稳因子分、噩梦夜惊因子分高于独生子女大学生,差异有统计学意义(t=-2.353,-2.369;P0.05);(3)Pearson相关分析显示,大学生睡眠质量与除受惩罚因子外的生活事件总分及各因子间均呈正相关(r=0.232,0.268,0.241,0.137,0.272,0.163;P0.01),睡眠不稳因子与生活事件总分及各因子间均呈正相关(r=0.284,0.250,0.230,0.161,0.181,0.354,0.229;P0.01),噩梦夜惊因子与生活事件总分及各因子间均呈正相关(r=0.205,0.150,0.188,0.159,0.179,0.175,0.179;P0.01);(4)多元回归分析显示,睡眠质量(SRSS)总分与生活事件(ASLEC)总分、人际关系因子、学习压力因子、丧失因子、健康适应因子、其他因子均有正向关联(Beta=0.232,0.268,0.241,0.137,0.272,0.163;P0.01),可解释变异率5.1%、6.9%、5.5%、1.6%、7.1%、2.4%。结论:大学生睡眠质量易受不良生活事件影响,应给予关注。     

抑郁症患者社会快感缺失与睡眠质量和睡眠信念的相关性

目的:探讨抑郁症患者社会快感缺失与睡眠质量及睡眠信念的关系。方法:收集42例抑郁症患者和43例健康者对照,采用社会快感缺失问卷(RSAS-C)、匹斯堡睡眠质量指数量表(PSQI)及睡眠个人信念和态度量表(DBAS)进行调查。结果:患者组RSAS-C(t=-3.18,P0.01)和PSQI总分(t=-8.84,P0.01)及各因子分均显著高于对照组,DBAS总分(t=4.52,P0.01)、失眠后果的估计(t=4.33,P0.01)和对睡眠的担心因子分(t=4.80,P0.01)均低于对照组,差异有显著性。Spearman相关分析显示,患者组RSAS-C评分与PSQI中睡眠障碍因子分呈正相关(r=0.327,P0.05),DBAS总分与PSQI总分呈负相关(r=-0.339,P0.05)。DBAS中对失眠后果的估计因子分与PSQI总分、睡眠质量、睡眠药物及睡眠效率因子分均呈负相关(r=-0.310,-0.337,-0.369,-0.326;P0.05)。余变量间的相关性均无统计学意义。结论 :抑郁症患者存在明显的社会快感缺失,睡眠质量变差以及存在较多错误的睡眠信念,并且患者睡眠质量与社会快感缺失存在相关。     

医学生睡眠质量的心理干预

目的:为了探讨心理干预对海南医学生睡眠质量干预的效果。方法:采用整群随机抽样的方法从海南医学院抽取2010级两个班级,一个班为实验组,一个班为对照组,进行睡眠质量的干预研究。用自制的睡眠质量影响因素调查表、IAII量表、PSQI和SCL-90量表效果测评。结果:用秩和检验分析表明,实验组和对照组间睡眠质量差值(Z=-3.203,P=0.001)、睡眠障碍差值(Z=-2.292,P=0.022)、日间功能障碍差值(Z=-2.051,P=0.040)和PSQI总分差值(Z=-3.370,P=0.001)差别均有统计学意义。干预前后PSQI总分差值与SCL-90总分差值间的相关系数高达0.542。多重线性回归分析表明,影响睡眠质量较大的因素有是否干预(β=0.189),精神病性得分差值(β=0.457)和网络总分差值(β=0.148)。结论:大学生处在青春发育后期,思想的不稳定期,通过积极的心理干预可以调整不良行为和提高心理素质,是提高睡眠质量的有效途径。     

某部新兵睡眠质量及影响因素调查

目的了解某部新兵的睡眠质量状况。方法整群抽取某部495名新兵采用自制的新兵心理卫生调查问卷及匹兹堡睡眠质量指数(PSQI)量表进行测试。结果新兵的睡眠质量异常检出率为13.54%,高于正常男性群体(χ2=7.96,P=0.005);新兵的主观睡眠质量(SSQ)、入睡潜伏时间(SL)、睡眠干扰因素(Sdi)、应用催眠药物(USM)、白天功能障碍(DD)分值及PSQI总分均高于正常男性群体(U=2.76~39.01,P0.01);Logistic回归分析显示:非自愿入伍(P0.001,OR=9.987,95%CI=4.609-22.866)、认为不适应部队生活(P0.001,OR=7.001,95%CI=3.018-16.981)及认为部队管理方式严格(P0.001,OR=3.096,95%CI=1.887-9.087)为新兵睡眠质量异常的显著危险因子。结论新兵的睡眠质量状况不容乐观,应当给予持续关注;乐观向上的心态有助于新兵睡眠质量的提升。     

某部军队医护人员睡眠质量及影响因素

目的:探讨某部102名军队医护人员睡眠质量及相关影响因素。方法:采用匹兹堡睡眠质量指数(PSQI)量表、症状自评量表(SCL-90)和自编一般情况调查表,对某部102名军队医护人员进行调查。结果:1某部102名军队医护人员PSQI总均分为(5.84±3.29)分,与国内正常人群比较,差异有统计学意义(t=7.26,P0.01);军队医护人员睡眠问题的检出率为23.5%,PSQI各项因子检出率居高的前三位分别是入睡时间(45.1%)、主观睡眠质量(26.5%)、睡眠障碍(24.5%);2PSQI总分与SCL-90总均分呈正相关(r=0.679,P0.01),经多元回归分析结果显示,SCL-90的抑郁、躯体化因子进入回归方程;3性别(r=-0.215,P0.05)、受教育程度(r=0.239,P0.05)与PSQI总分相关。结论:某部军队医护人员睡眠质量较一般人群差,睡眠质量与心理健康状况密切相关,其中躯体化和抑郁情绪对睡眠质量有预测效应。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.